Protection of nerve function during transoral endoscopic thyroidectomy by vestibular approach
10.3760/cma.j.cn115330-20200526-00447
- VernacularTitle:经口腔前庭入路腔镜甲状腺手术中神经功能的保护
- Author:
Zhen WU
1
;
Jugao FANG
;
Xiao CHEN
;
Lizhen HOU
;
Qi ZHONG
;
Hongzhi MA
;
Yang ZHANG
;
Xixi SHEN
Author Information
1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 100730；聊城市人民医院 山东第一医科大学附属聊城医院甲状腺乳腺外科，山东省聊城市 252000
- Keywords:
Thyroid neoplasms;
Surgical procedures, minimally invasive;
Oral vestibular;
Endoscopy;
Neuroprotection
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2020;55(10):893-898
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the method of functional protection in transoral endoscopic thyroidectomy by vestibular approach.Methods:Retrospective analysis was performed on the case data of 66 patients who underwent transoral endoscopic thyroidectomy by vestibular approach in the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital from February 2018 to February 2020. There were 11 males and 55 females aged 22-64 years, including 19 patients with benign diseases and 47 patients with malignant diseases. Important neurological functions were protected by a combination of anatomical exposure and intraoperative nerve monitoring. The clinical data and the effect of neurofunctional protection were summarized. SPSS 25.0 software was used for statistical analysis.Results:All operations were successfully completed with none transferred to open surgery. Three weeks after surgery, the numbness and tingling symptoms in the lower jaw and lower lip were basically relieved. There was no permanent mental nerve palsy, no permanent recurrent laryngeal nerve palsy but 2 cases with temporary recurrent laryngeal nerve palsy, no external branch injury of superior laryngeal nerve. There were 3 cases of temporary parathyroid gland dysfunction, 1 case of neck infection, 2 cases of subcutaneous effusion, 1 case of neck skin injury, and 2 cases of postoperative eye conjunctivitis.Conclusion:In transoral endoscopic thyroidectomy by vestibular approach, anatomical exposure can decrease mental nerve injury, and anatomical exposure combined with intraoperative nerve monitoring can protect the functions of the external branches of the superior laryngeal nerve and the recurrent laryngeal nerve.
